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{{refimprove|date=September 2010}}
'''Epidemiology of periodontal disease''' is the study of patterns, causes, and effects of periodontal diseases. Periodontal disease is a disease affecting the tissue surrounding the teeth. This causes the gums and the teeth to separate making spaces that become infected. The immune system tries to fight the toxins breaking down the bone and tissue connecting to the teeth to the gums. The teeth will have to be removed. This is an advance stage of gum disease that has multiple definitions. Adult periodontitis affects less than 10 to 15% of the population in industrialized countries, mainly adults around the ages of 50 to 60. The disease is now declining world-wide.
==Prevalence of
Many studies look at the prevalence of “advanced [[periodontitis]]”, but have differing definitions of this term. Generally though, severe forms of periodontitis do not seem to affect more than 15% of the population of [[Industrialization|industrialized]] countries. The proportion of such subjects increases with age and seems to peak between 50 and 60 years. A later decline in prevalence may be due to [[tooth loss]].
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The use of the CPITN system for [[Epidemiology|epidemiological]] purposes has flaws, which are grounded in a number of historical truths. At the time the system was designed, the initiation of periodontal disease was thought to develop from a continuum from an inflammation-free state to [[gingivitis]], to [[Calculus (dental)|calculus deposition]] and pocket formation and then to progressive disease. Treatment concepts were based on the concept of pocket depths being the most critical criterion for surgical versus non-surgical treatments. This index was also designed to screen large populations to determine treatment needs and formulate preventive strategies, not to describe the prevalence and severity of periodontal diseases.
Albandar (1999) reported on data from the Third [[National Health and Nutrition Examination Survey]] (NHANES III).
Hugoson (1998) examined three random samples of 600, 597 and 584 subjects in 1973, 1983 and 1993 respectively. These subjects were aged 20–70 years. The severity of disease was divided into five groups, with group 5 having the most severe disease. There was an apparent increase from 1% to 2% to 3% over the three study periods, which may have been due to an increase of [[Tooth (human)|dentate]] subjects in the older age groups.
Susin 2004 examined a representative sample of 853 dentate individuals in [[Brazil]] who were selected by a multistage probability sampling method. They had a full-mouth clinical examination of six sites per tooth and answered a structured written questionnaire. Seventy-nine percent (79%) and 52% of the subjects and 36% and 16% of the teeth per subject had CAL >5 and >7mm, respectively.{{Citation needed|date=October 2010}}
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Baelum 1996 recalculated their previous data from [[Kenya]]n and [[China|Chinese]] populations to conform to the methods of examination and data presentation utilized in six other surveys. They did not find that the data supported the traditional [[generalization]] that prevalence and severity of periodontitis is markedly increased in African and Asian populations.{{Citation needed|date=October 2010}}
==Incidence of
Like measurements of prevalence of periodontitis, the measurement of incidence will vary depending upon the case definition of the disease. Often “incidence” refers to new sites that meet the definition of periodontitis, even if they occur within a person that already has other diseased sites.{{Citation needed|date=October 2010}}
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Gilbert 2005 describes a prospective study of persons in [[Florida]] > 45 years old. In-person interviews and examinations were conducted at baseline and 48 months. The study size was 560 persons and at the 48-month examination, 22% of persons and 1.8% of teeth had attachment loss incidence.{{Citation needed|date=October 2010}}
==Early
Albandar 2002 examined 690 school attendees aged 12–25 years. They found that 2.3% had generalized EOP and 4.2% had localized EOP. This total of 6.5% contrasted with 1.8% for [[Nigeria]], 3.1–3.7% for Brazil, 6.8% in [[India]] and 8% in [[Sudan]]. The prevalence in [[Caucasian race|Caucasian]] populations is in the 0.1% to 0.2% range and may indicate that subjects originating from the sub-Saharan countries of Africa may be at higher risk of developing EOP.{{Citation needed|date=October 2010}}
Tinoco 1997 examined 7843 children between the ages of 12
Lopez 2001 examined 9,162 high school children for clinical attachment loss in 6 sites of first and second [[molar (tooth)|molars]] and [[incisor]]s. Overall, CAL >1mm was seen in 69.2% of the students; >2mm in 16% of the students and >3mm in 4.5%. They noted that while the distribution of CAL was markedly skewed, it followed a continuum of [[disease severity]]. No sharp distinction exists between periodontal health and disease among [[Chile]]an adolescents.{{Citation needed|date=October 2010}}
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Levin 2006 studied 642 young [[Israel]]i army recruits (562 men and 80 women) – clinical periodontal examination of four first molars and eight incisors and [[radiograph]]s were completed. Aggressive periodontitis was found in 5.9% of the subjects (4.3% localized and 1.6% generalized). This was significantly associated with current [[smoking]] and ethnic origin (North African).{{Citation needed|date=October 2010}}
Eres 2009 examined 3,056 students between the ages of 13
==Tooth loss==
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==References==
{{reflist|30em}}
==Further reading==
{{refbegin|30em}}
*{{cite journal |last1=Albandar |first1=JM |last2=Brown |first2=LJ |last3=Löe |first3=H |title=Dental caries and tooth loss in adolescents with early-onset periodontitis |journal=Journal of
* {{cite journal |last1=Albandar |first1=JM |last2=Brunelle |first2=JA |last3=Kingman |first3=A |title=Destructive periodontal disease in adults 30 years of age and older in the United States, 1988-1994 |journal=Journal of
*{{cite journal |doi=10.1034/j.1600-051X.2002.290906.x |last1=Albandar |first1=JM |last2=Muranga |first2=MB |last3=Rams |first3=TE |title=Prevalence of aggressive periodontitis in school attendees in Uganda |journal=Journal of
*{{cite journal |doi=10.1111/j.1600-0765.1996.tb00459.x |last1=Baelum |first1=V |last2=Chen |first2=X |last3=Manji |first3=F |last4=Luan |first4=WM |last5=Fejerskov |first5=O |title=Profiles of destructive periodontal disease in different populations |journal=Journal of
*{{cite journal |doi=10.1111/j.1600-0528.1997.tb00927.x |last1=Baelum |first1=V |last2=Luan |first2=WM |last3=Chen |first3=X |last4=Fejerskov |first4=O |title=Predictors of tooth loss over 10 years in adult and elderly Chinese |journal=Community
*{{cite journal |doi=10.1111/j.1600-0528.1997.tb00938.x |last1=Baelum |first1=V |last2=Luan |first2=WM |last3=Chen |first3=X |last4=Fejerskov |first4=O |title=Predictors of destructive periodontal disease incidence and progression in adult and elderly Chinese |journal=Community
*{{cite journal |doi=10.1111/j.1600-0765.1997.tb00567.x |last1=Beck |first1=JD |last2=Sharp |first2=T |last3=Koch |first3=GG |last4=Offenbacher |first4=S |title=A 5-year study of attachment loss and tooth loss in community-dwelling older adults |journal=Journal of
*{{cite journal |last1=Bourgeois |first1=DM |last2=Doury |first2=J |last3=Hescot |first3=P |title=Periodontal conditions in 65-74 year old adults in France, 1995 |journal=International
*{{cite journal |last1=Bourgeois |first1=D |last2=Bouchard |first2=P |last3=Mattout |first3=C |title=Epidemiology of periodontal status in dentate adults in France, 2002-2003 |journal=Journal of
*{{cite journal |last1=Burt |first1=B |author2=Research, Science and Therapy Committee of the American Academy of Periodontology |title=Position paper: epidemiology of periodontal diseases |journal=Journal of
*{{cite journal |last1=Ereş |first1=G |last2=Saribay |first2=A |last3=Akkaya |first3=M |title=Periodontal treatment needs and prevalence of localized aggressive periodontitis in a young Turkish population |journal=Journal of
* {{cite journal |doi=10.1111/j.1600-051X.1998.tb02485.x |last1=Hugoson |first1=A |last2=Norderyd |first2=O |last3=Slotte |first3=C |last4=Thorstensson |first4=H |title=Distribution of periodontal disease in a Swedish adult population 1973, 1983 and 1993 |journal=Journal of
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